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The procedure starts by using the Valvulotomy instrument shown below to remove the defectives valve leaflets.
By bringing the two halves of the instrument together the leaflets are cut off at the base and captured by the basket.
Then the expandable stent containing a bovine tissue valve is introduced in place of the defective valve.
This has the advantage of preventing renarrowing of the area and replacing the valve in case it was there for a reason. At least will prevent Global Amnesia episodes if patient goes in Valsalva maneuver (straining).
This is a close up picture of the instument.
Before people start to sign up for the procedure keep in mind that
1: the valvulotomy instrument is not yet available and is being patented by the Zamboni group.
2: the stent-valve is only available for heart aortic valve replacement and it will need to be modified to be used in the IJV. The stent should be of mild conical shape to prevent downstream migration.
Just food for thought.

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Thanks for posting this, Nunzio, the pictures help explain it well. By the time this will be ready for use in CCSVI, trials will have been completed seeing if stents are a viable choice, as this appears to be a stent connected with a new valve. It is good if we have options down the road!

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